@article{Sattar_Ahmed_Akhter_Aijaz_Lakhani_Malik_Pathan_2019, title={In-Hospital outcomes in acute coronary syndrome patients with concomitant severe chronic kidney disease undergoing percutaneous coronary intervention}, volume={35}, url={https://www.pjms.org.pk/index.php/pjms/article/view/276}, DOI={10.12669/pjms.35.2.276}, abstractNote={<p><em><strong>Objective:</strong></em> To determine in-hospital mortality and major adverse cardiac events (MACE) in acute coronary syndrome (AMI) patients with underlying severe chronic kidney disease (CKD) undergoing percutaneous coronary intervention (PCI).</p> <p><em><strong>Methods:</strong></em> We conducted a retrospective cohort study from June’2013-December’2017 at Tabba Heart Institute, Karachi. Data was drawn from institutes’ database modeled after US National Cardiovascular data CathPCI registry. All AMI (STEMI: ST-elevation myocardial infarction and NSTEMI: non-ST-elevation myocardial infarction) patients undergoing PCI with creatinine clearance &lt;30ml/min or ESRD on hemodialysis were included in the study.</p> <p><em><strong>Results:</strong></em> During 54 months study period, 160 severe CKD patients underwent PCI. Mean age was 62.9±12.2 years. Men were 61.9%, hypertensive (81.3%) and diabetic (63.8%). Excluding dialysis patients, Creatinine clearance was 21.1±6.6ml/min/1.73m2. STEMI were 46.9% and 61.9% were Killip I. Mean SYNTAX score was 16.6±7.3. MACE occurred in 32.5% patients, of which 6(11.5%) had new hemodialysis and mortality: 17.5% were deceased. MACE predictor were cardiogenic shock (OR: 2.81, 95%CI: 1.17-6.74) and prior heart failure (OR: 6.84, 95%CI: 1.39-33.74), Predictor of mortality was cardiogenic shock or cardiac arrest (OR: 7.90, 95%CI: 2.95-21.17).</p> <p><em><strong>Conclusion:</strong></em> Severe CKD patients undergoing PCI for AMI have drastically poor outcomes therefore individualization and patient-centric care management is mandatory.</p> <p><em><strong>How to cite this:</strong></em><br>Sattar S, Ahmed N, Akhter Z, Aijaz S, Lakhani S, Malik R, et al. In-Hospital outcomes in acute coronary syndrome patients with concomitant severe chronic kidney disease undergoing percutaneous coronary intervention. Pak J Med Sci. 2019;35(2):291-297.&nbsp;&nbsp;doi: https://doi.org/10.12669/pjms.35.2.276</p> <p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p&gt;}, number={2}, journal={Pakistan Journal of Medical Sciences}, author={Sattar, Saadia and Ahmed, Naseer and Akhter, Zohaib and Aijaz, Saba and Lakhani, Shakir and Malik, Rehan and Pathan, Asad}, year={2019}, month={Mar.} }